Hafnarstræti 18, 600 Akureyri, ground floor of a two-story commercial building, converted to office space. Built in 1965, concrete construction with large glass storefront. Main entrance is at street level. No elevator. Street parking. No security system. Current conditions: 8°C, overcast, light breeze. GPS coordinates: 65.6831° N, 18.0914° W. Nearest landmark: Akureyri Art Museum.
35-year-old male, experiencing severe shortness of breath and wheezing. Primary symptoms: Marked respiratory distress, audible wheezing, difficulty speaking in full sentences, use of accessory muscles. Secondary symptoms: Mild chest tightness, anxiety, pale skin. Patient is sitting upright, leaning forward. Medical history: Known asthma since childhood, seasonal allergies. Medications: Salbutamol inhaler (Ventolin) PRN, Fluticasone inhaler (Flovent) daily, Loratadine 10mg daily. No known allergies. Last meal was a light lunch at 13:00. Has used his salbutamol inhaler 4 times in the last hour with no relief.
Timeline: 14:00 hours: Patient started feeling mild shortness of breath. 14:15 hours: Symptoms worsened, started using salbutamol inhaler. 14:30 hours: Used salbutamol inhaler again, no improvement. 14:40 hours: Symptoms progressively worsened, increasing wheezing and difficulty breathing. 14:45 hours: Patient called emergency services. 14:47 hours: Current time, patient is in severe respiratory distress. Prior Events: Patient reports a history of asthma exacerbations during the spring season. He has been exposed to pollen today. He has not had a recent respiratory infection. Last medical check-up was 6 months ago, routine follow-up. Patient is at his workplace.
Initial Impression: Acute Asthma Exacerbation Justification for F2 Classification: - Significant respiratory distress with wheezing and accessory muscle use - Failure of initial bronchodilator treatment (salbutamol) - Potential for rapid deterioration - Time-sensitive condition requiring immediate medical intervention Differential Diagnoses: 1. Acute Asthma Exacerbation (high probability) 2. Anaphylaxis (less likely, no known allergies or recent exposures) 3. Acute Bronchitis (less likely given the history of asthma) 4. Pneumothorax (less likely, no history of trauma) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen administration - Further bronchodilator therapy (nebulized salbutamol/ipratropium) - Corticosteroid administration - Preparation for transport to nearest hospital with respiratory services